§ 32.1-138.9. Standards for approval
Each private review agent shall file an application with the Department which shall meet the following minimum standards and any additional standards established by regulation pursuant to § 32.1-138.15, and pay a filing fee established by the Department, in order to be approved by the Department:
1. A description of the procedures to be used in evaluating proposed or delivered hospital, medical, or other health care services;
2. The procedures by which patients or providers may seek reconsideration of determinations by private review agents;
3. The type and qualifications of the personnel either employed or under contract to perform the utilization review;
4. Procedures and policies which ensure that patient-specific medical records and information shall be kept strictly confidential except as authorized by the patient or by regulations adopted pursuant to this article; and
5. Assurances that reviewers be readily accessible by telephone to patients and providers at least forty hours per week during normal business hours.
(1990, c. 826, § 38.2-5302; 1998, c. 129.)
Sections: Previous 32.1-138.2 32.1-138.3 32.1-138.4 32.1-138.5 32.1-138.6 32.1-138.7 32.1-138.8 32.1-138.9 32.1-138.10 32.1-138.11 32.1-138.12 32.1-138.13 32.1-138.14 32.1-138.15 32.1-139 NextLast modified: April 16, 2009